Active NPI
Chicago Christian Counseling Center Inc
- Clinical Social Worker
- Orland Park, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- CHICAGO CHRISTIAN COUNSELING CENTER INC
- Practice address
- 15127 S 73Rd Ave
G
Orland Park, IL 60462-4398 - Phone
- (708) 845-5500
- Fax
- (708) 845-5505
- NPI assigned
- May 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amanda Kuba
- Title
- Billing Manager
- Phone
- (708) 845-5500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Clinical Psychologist | 103TC0700X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
15127 S 73Rd Ave
G
Orland Park, IL 60462-4398
Mailing address
15127 S 73Rd Ave
G
Orland Park, IL 60462-4398
Phone (800) 361-6880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040615001668 | IL | Part B Supplier - Clinic/Group Practice | 1052395258 |
Receives reassigned benefits from 25 practitioners Practice locations: South Holland, IL; Orland Park, IL; New Lenox, IL; Lombard, IL; Evergreen Park, IL; Chicago, IL |
| O20090929000534 | IN | Part B Supplier - Clinic/Group Practice | 1052395258 |
Receives reassigned benefits from 6 practitioners Practice locations: Schererville, IN |
National Provider Directory
National Provider Directory- Tax ID family
- Chicago Christian Counseling Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Psychologist
- Schereville, IN
- NPI 1053445239
Locations
1347 S State St
Chicago, IL 60605
1010 E 79th St
Chicago, IL 60619
Phone (312) 613-8792
6334 W Diversey Ave
Chicago, IL 60639
1401 W Hollywood Ave
Chicago, IL 60660
111 W Jackson Blvd
Chicago, IL 60604
Phone (312) 251-2300
2020 S Meyers Rd
Lombard, IL 60148
500 Gougar Rd
New Lenox, IL 60451
321 W Maple St
Ste 201
New Lenox, IL 60451
Phone (815) 485-1911
900 Jorie Blvd
Ste 60
Oak Brook, IL 60523
Phone (630) 990-1935
1010 Lake St
Ste 107
Oak Park, IL 60301
15127 S 73rd Ave
Ste G
Orland Park, IL 60462
Phone (630) 990-1935
15127 S 73rd Ave
Orland Park, IL 60462
Phone (708) 586-9608
12410 S Van Dyke Rd
Plainfield, IL 60585
400 Lathrop Ave
Ste LL95
River Forest, IL 60305
16107 La Salle St
South Holland, IL 60473
910 Main St
West Chicago, IL 60185
Phone (630) 990-1935
962 W US Highway 30
Unit 8
Schererville, IN 46375
Phone (219) 864-4363
Practitioners & affiliated clinicians
Practitioners 89
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Professional Counselor
- Tinley Park, IL
- NPI 1730402884
IL, Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1600992000000",
"number": "1083664510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15127 S 73RD AVE",
"address_2": "G",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604624398",
"telephone_number": "800-361-6880",
"fax_number": "708-845-5505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15127 S 73RD AVE",
"address_2": "G",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604624398",
"telephone_number": "708-845-5500",
"fax_number": "708-845-5505"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHICAGO CHRISTIAN COUNSELING CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-12",
"last_updated": "2020-09-25",
"certification_date": "2020-09-25",
"status": "A",
"authorized_official_last_name": "KUBA",
"authorized_official_first_name": "AMANDA",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "708-845-5500"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.